Provider Demographics
NPI:1154547149
Name:HOFFMEYER, LISA JANE (PHD LICENSED PSCYH)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:JANE
Last Name:HOFFMEYER
Suffix:
Gender:F
Credentials:PHD LICENSED PSCYH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 MADISON MILLS CT
Mailing Address - Street 2:
Mailing Address - City:CATONSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21228-2538
Mailing Address - Country:US
Mailing Address - Phone:410-788-2686
Mailing Address - Fax:410-321-9531
Practice Address - Street 1:2324 W JOPPA RD
Practice Address - Street 2:SUITE 420
Practice Address - City:LUTHERVILLE
Practice Address - State:MD
Practice Address - Zip Code:21093-4615
Practice Address - Country:US
Practice Address - Phone:410-983-2698
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD2821103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist